Kornimate/medical-research-clean huggingface dataset:
pharmacodynamic effects of prasugrel compared with ticagrelor in patients with coronary artery disease

Conditions: Coronary Artery Disease

Summary: recently, two p2y12 receptor inhibitors have been approved for clinical use: prasugrel and ticagrelor. both prasugrel and ticagrelor have shown to be associated with more potent antiplatelet effects compared with clopidogrel and are associated with an improved net clinical benefit. however, to date there are limited head-to-head comparisons of these two new agents.

dual antiplatelet therapy consisting of aspirin and clopidogrel is the cornerstone of treatment for prevention of thrombotic events in patients with coronary artery disease (cad) undergoing percutaneous coronary intervention (pci). however, there are a considerable number of patients who continue to have recurrent ischemic events despite this treatment regimen. these observations underscore the need for more potent antiplatelet therapies. recently, two p2y12 receptor inhibitors have been approved for clinical use: prasugrel and ticagrelor. both prasugrel and ticagrelor have shown to be associated with more potent antiplatelet effects compared with clopidogrel. these more favorable pharmacodynamic effects translate into reduced ischemic event rates, at the expense of an increased risk of bleeding in patients with acute coronary syndromes. overall, these drugs are associated with an improved net clinical benefit. these findings from large-scale clinical investigations have led to approval of prasugrel and ticagrelor. however, to date there are limited head-to-head comparisons of these two new agents.

Eligibility criteria:
inclusion criteria: * patients with known coronary artery disease * on maintenance treatment with aspirin (81 mg per day) and clopidogrel (75 mg per day) for at least 1-month as per standard of care. * age between 18 and 74 years old. exclusion criteria: * history of stroke, transient ischemic attack or intracranial bleeding. * known allergies to aspirin, prasugrel, ticagrelor, or clopidogrel. * weight \<60kg * on treatment with oral anticoagulation (coumarin derivate, dabigatran). * hemoglobin\<10 gm/dl * platelet count \<80x106/ml * active bleeding or hemodynamic instability. * creatinine clearance \<30 ml/minute. * baseline alt \>2.5 times the upper limit of normal. * patients with sick sinus syndrome (sss) or high degree av block without pacemaker protection. * drugs interfering with 2c19 metabolism (to avoid interaction with clopidogrel): , fluconazole (diflucan), ketoconazole (nizoral), voriconazole (vfend), etravirine (intelence), felbamate (felbatol), fluoxetine (prozac, serafem, symbyax), fluvoxamine (luvox), and ticlopidine (ticlid). * drugs interfering cyp3a4 metabolism (to avoid interaction with ticagrelor): ketoconazole, itraconazole, voriconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, atazanavir, and telithromizycin. * pregnant females\*. \*women of childbearing age must use reliable birth control (i.e. oral contraceptives) while participating in the study.

Keywords: coronary artery disease dual antiplatelet therapy prasugrel ticagrelor
clinical trial of elemene injection/elemene oral emulusion in combination with the best supportive treatment in the treatment of advanced primary liver cancer

Conditions: Advanced Primary Liver Cancer

Summary: clinical trial of elemene injection/elemene oral emulusion in combination with the best supportive treatment in the treatment of advanced primary liver cancer

patients with advanced primary liver cancer will be enrolled in the trial , then the patients will be treated with the elemene injection/elemene oral emulusion in combination with the best supportive treatment .the purpose of the study is to evaluate the effect and safety of the elemene injection/elemene oral emulusion in combination with the best supportive treatment in the treatment of advanced primary liver cancer

Eligibility criteria:
inclusion criteria: * 18-75 years old，no limit on gender * patients who are confirmed locally advanced or metastatic primary liver cancerin accordance with the clinical diagnostic criteria , or by pathological histology or cytology examination, patients who are unable to accept surgery,radiofrequency ablation、tace and local therapy ，orlocal treatment progress failed * have systematic treatment before( including systematic chemotherapy and/or molecular targeted therapy) , but the treatment was unsuccessed and the tumor progress * according to recist v1.1，1at least has one measurable lesions * ecog score ≤2 * patients who have primary liver cancer with child - pugh liver function grade rating a or better b(score\<=7) * laboratory inspection basically meets the following requirements： blood test：a. hb\>=90g/l(without blood transfusion within 14 days), b. anc\>=1.5×10\^9/l, c. plt\>=60×10\^9/l. biochemical test：a. alb\>=29g/l(without blood transfusion within 14 days), b. alt and ast \<=5uln, c. tbil\<=2uln, d. cr\<=1.5uln. blood coagulation function:pt\<=uln+6seconds. * life expectancy of at least 3 months * subjects join the study voluntarily, sign a consent form, have good compliance, and comply with follow-up. exclusion criteria: * patients have other anti-cancer treatment ， including α-ifn，arsenious acid injection and other traditional chinese medicine patent prescription for treating cancer * in the past or at the same time,patients were diagnosed with other malignant tumor which have not been cured. as for skin basal cell carcinoma and cervical carcinoma in situ,they can be excepted * patients with severe acute infection and cann't be controled , chronic suppurative infection , body temperature\>=39℃ ， pleural effusion（medium and large） combined with infection * women who is pregnant or during breast feeding and not willing to contraception during the test * coagulation dysfunction(pt\>16 seconds ， aptt\>43 seconds , tt\>21 seconds , fib\<2g/l) , with bleeding tendency or the presence of vital organ thrombosis (lung, brain) is receiving thrombolytic or anticoagulant therapy * with a mental illness, or has a history of drugs abuse * patients accepted any experimental drugs in the past 4 weeks * other reasons the researchers think not suitable
study to evaluate the effectiveness of the personal pap smear device™ for collection of cervical cells

Conditions: Cervical Cancer Screening

Summary: this purpose of this research study is to determine the effectiveness of the personal pap smear tm device to collect adequate cervical cell samples for cytology examination when compared with the rover cervex-brush (cervix-examination brush).

to determine the effectiveness of the personal pap smear tm device to collect adequate (as defined by bethesda guidelines 2014) cervical cell samples for cytology examination as compared with the rover cervex-brush (cervix-examination brush).

Eligibility criteria:
inclusion criteria: * adult women, aged 21-65 years old. * do not have any medical or psychiatric condition affecting the ability to give voluntary informed consent. * be able to read and understand english exclusion criteria: * participants currently on menses * inability to provide informed consent * previous total hysterectomy * history of radiation treatment for cervical cancer * pregnancy * medical condition that interferes with conduct of study, in investigator's opinion * evidence of active cervical infection requiring treatment * known bleeding diathesis

Keywords: pap smear collection
study using cp-461 to treat advanced prostate cancer

Conditions: Prostate Cancer

Summary: the purpose of this study is to investigate whether an investigational drug, cp-461, is safe and effective for the treatment of patients with prostate cancer and who have measurable disease.


Eligibility criteria:
eligibility criteria: * male 18 years of age. * histologically confirmed adenocarcinoma of the prostate, stage d1 or d2. * failure of androgen ablation (orchiectomy or lhrh, flutamide). * patients must have psa progression and progression in measurable disease. * no prior history of systemic chemotherapy. * no investigational drugs within 4 weeks of study entry. * no radiation therapy or hormonal therapy within 4 weeks of study entry. * no isotope therapy within 6 weeks of study entry. * no antiandrogens within 4 weeks of study entry. patients must continue lhrh. * if patients had prior surgery, it must be at least 21 days prior to study entry, and the patient must have recovered from all side effects. * patients must have stopped bisphosphonates 28 days prior to study entry. * no prior malignancy allowed except for adequately treated basal cell or squamous cell skin cancer, or adequately treated stage i or ii cancer from which the patient is currently in remission, and has been disease free for at least 5 years. * patients must have recovered from major infections and/or surgical procedures, and in the opinion of the investigator not have significant active concurrent medical illness, such as a history of significant neurologic or psychiatric disorders including psychotic disorders, dementia, or seizures that would preclude protocol treatment or survival. * all patients must be informed of the investigational nature of the study and must sign and give written informed consent in accordance with institutional and federal guidelines. * no other chemotherapeutic, biological response modifiers, radiation therapy, corticosteroid therapy, or hormonal concomitant therapy (except continuation of lhrh) may be given during treatment. patients should not be planning on receiving concomitant bisphosphonates. * ecog performance status = 0-3. * wbc \> or = 3500/ul or anc \> or = 1500/ul. * bilirubin \< or = uln. * creatinine \< or = 2.0 mg/dl. * platelets \> or = 100,000/ul. * alt or ast \< 2.5 x uln.

Keywords: prostate cancer prostate
hypertension patients on drug medication adherence and rational medication use

Conditions: Hypertension Patients

Summary: this research will be conducted to determine the effects of education and telephone counseling given to hypertension patients on drug treatment compliance and rational drug use.

this research will be conducted to determine the effects of education and telephone counseling given to hypertension patients on drug treatment compliance and rational drug use. research hypotheses h0: education and telephone counseling given to hypertension patients do not affect drug treatment compliance. h1: education and telephone counseling given to hypertension patients increase drug treatment compliance. h0: education and telephone counseling given to hypertension patients do not affect rational drug use. h1: education and telephone counseling given to hypertension patients increase rational drug use. this study was planned as a single-blind randomized controlled experimental study.

Eligibility criteria:
inclusion criteria: * - diagnosed with hypertension, * hypertension disease duration of at least 6 months, * using at least one drug due to hypertension, * 18 years old and over * literate, * living in the town centre, * owns a phone * open to communication and cooperation, * patients willing to participate in the study will be included in the study. exclusion criteria: * having a psychiatric illness * hearing loss, * can't understand or speak turkish and * patients who do not wish to continue the study will be excluded from the study.

Keywords: hypertension tele nursing education rational medication use drug medication adherence nursing
effects of fimasartan on insulin secretion in type 2 diabetic patients

Conditions: Diabetes Mellitus; Hypertension

Summary: this study was designed to evaluate the effect of arb in improving insulin secretion in patients with type 2 diabetes. the investigators also aimed to evaluate if there are potential synergisms between arb and dpp4 inhibitors in improving insulin secretion and urinary albumin secretion in diabetic patients.

angiotensin ii has been reported to insulin secretion in beta cells. angiotensin ii indirectly improves insulin secretion in beta cells via vasoconstriction and reduced islet blood flow. chronic exposure to high glucose or high fat increases expression of at1r (angiotensin type 1 receptor), leading to reactive oxidative stresses, inflammation, and apoptosis in beta cells, finally decreased insulin formation and secretion. some studies showed the beneficial effect of blocking at1r on insulin secretion and beta cell proliferation in animal models using angiotensin receptor blocker (arb). furthermore, 26 weeks of valsartan treatment improved insulin secretion in humans with impaired glucose regulation.

Eligibility criteria:
inclusion criteria: * aged 20\~80 years * type 2 diabetic patients diagnosed more than 6 months ago * hba1c ≤8.5% at screening * no change of oad within the 3 months before screening * sbp \<140 mmhg and dbp \<90 mmhg with anti-hypertensive drug at screening * sbp ≥140 mmhg or dbp ≥80 mmhg without anti-hypertensive drug at screening exclusion criteria: * type 1 diabetic patients or active insulin treatment at screening * treatment with arb or acei within 1 month prior to screening * uncontrolled hypertension with sbp \>170 mmhg or dbp \>100 mmhg * pregnancy or lactation * elevated liver enzyme (ast or alt \> 3 times the unl) or elevated serum cr (≥1.5 mg/dl in men and 1.4 mg/dl in women)
bioequivalency study of 450 mg lithium carbonate under fed conditions

Conditions: Bipolar Disorder

Summary: the objective of this study was to assess the bioequivalence of two roxane lithium carbonate 450 mg extended release tablet formulations compared to glaxosmithkline's eskalith cr 450 mg extended release tablet under fed conditions using a single-dose, randomized, three-treatment, three-period, six-sequence crossover design.


Eligibility criteria:
inclusion criteria: * no clinically significant abnormal findings on the physical examination, medical history, or clinical laboratory results during screening. exclusion criteria: * participation in a clinicl trial within 30 days prior to study initiation. * positive test for hiv, hepatitis b, or hepatitis c. * treatment with known enzyme altering drugs.
exercise capacity in bronchiectasis resection

Conditions: Bronchiectasis

Summary: bronchiectasis can be defined as an abnormal and irreversible dilatation of the bronchial tree due to repeated cycles of inflammation and infection, resulting in progressive loss of lung function. the surgical treatment by pulmonary resection or even lung transplantation is indicated in cases of bronchiectasis primary nonresponsive to appropriate medical treatment, or when associated with serious complications. there are few literature data on the influence of bronchiectasis in exercise capacity, quality of life and functional capacity, and the impact of lung resection in patients with this diagnosis. the primary objective of this study is to evaluate prospectively the impact of lung resection on exercise capacity in patients with clinical and radiological diagnosis of bronchiectasis. the secondary objective of this study is to evaluate the impact of lung resection on quality of life and lung function and to analyze the the presence of predictors of postoperative functional deterioration and the occurrence of complications.


Eligibility criteria:
inclusion criteria: * clinical and radiographic diagnosis of bronchiectasis; * lack of adequate response to clinical treatment after 1 year of follow-up and / or presence of disease complications; * agreement to participate of the study by signing of the informed consent term exclusion criteria: * comorbidities that prevent the patient to undergo general anesthesia; * musculoskeletal and/or psychomotor disability to perform pulmonary function tests and cardiopulmonary exercise tests; * inability to understand the quality of life questionnaires; * age over 90 years or less 18 years.

Keywords: bronchiectasis quality of life respiratory function tests exercise test
rehabilitation after breast cancer

Conditions: Breast Cancer

Summary: the aim of the study is to evaluate whether a screening-based individually tailored nurse navigator intervention compared to standard care significantly reduce psychological and physical symptoms among women being treated for breast cancer who had moderate-to-severe distress (score ≥ 7 on the distress thermometer).

during a 2-year period, 758 patients newly diagnosed with breast cancer will be screened for inclusion at the section of breast surgery at rigshospitalet, copenhagen. of these 324 participants enter the randomized controlled trial (rct) and are randomized in a computer-generated sequence of 1:1 to the intervention (nurse-navigation) or control group (standard care). a total of 432 participants will enter an observational questionnaire study. all participants are followed for 1,5 years.

Eligibility criteria:
inclusion criteria: * newly diagnosed with breast cancer (i.e. prior to surgery), scheduled for breast cancer surgery at section of breast surgery at rigshospitalet, 18 years or above, danish citizen, read, understand and speak danish, female gender,signed written informed consent. those who experience high psychological distress (score ≥ 7 on the distress thermometer) will enter the rct whereas those who experience low psychological distress (score \< 7 on the distress thermometer) will be followed in an observational questionnaire study. exclusion criteria: * no severe cognitive problems or dementia, no severe psychiatric disease requiring treatment, e.g. schizophrenia, alcohol or narcotic dependence,

Keywords: breast cancer, psychosocial intervention
spatial radiogenomics of ovarian cancer

Conditions: Ovarian Cancer

Summary: the biological spatial and temporal heterogeneity of high grade serous ovarian carcinoma (hgsoc) severely impacts the effectiveness of therapies and is a determinant of poor outcomes. current histological evaluation is made on a single tumour sample from a single disease site per patient thus ignoring molecular heterogeneity at the whole-tumour level, key for understanding and overcoming chemotherapy resistance. imaging can play a crucial role in the development of personalised treatments by fully capturing the disease's heterogeneity. radiomics quantify the image information by capturing complex patterns related to the tissue microstructure. this information can be complemented with clinical data, liquid biopsies, histological markers and genomics ("radiogenomics") potentially leading to a better prediction of treatment response and outcome. however, the extracted quantitative features usually represent the entire tumour, ignoring the spatial context. on the other hand, radiomics-derived imaging habitats characterize morphologically distinct tumour areas and are more appropriate for monitoring the changes in the tumour microenvironment over the course of therapy. in order to successfully incorporate the habitat-imaging approach to the clinic, histological and biological validation are crucial. however, histological validation of imaging is not a trivial task, due to issues such as unmatched spatial resolution, tissue deformations, lack of landmarks and imprecise cutting. patient-specific three-dimensional (3d) moulds are an innovative tool for accurate co-registration between imaging and histology. the aim of this study is to optimize and integrate such an automated computational 3d-mould co-registration approach in the clinical work-flow in patients with hgsoc. the validated radiomics-based tumour habitats will also be used to guide tissue sampling to decipher their underlying biology using genomics analysis and explore novel prediction markers.


Eligibility criteria:
inclusion criteria: * patients with suspected hgsoc scheduled to undergo primary debulking surgery (pds) or interval debulking surgery (ids) will be recruited in the study. prior histopathological confirmation of hgsoc will be required for ids. the pds cases without prior histological diagnosis will be selected on the basis of clinical suspicion (elevated serum ca125 and ct imaging). exclusion criteria: * patients less than 18 years old * pregnancy * non-serous high grade epithelial ovarian cancer (serous low grade, mucinous, clear cell carcinoma, endometrioid or non-epithelial ovarian cancer) * early stage disease (i and ii stage) * ct or mri scan not available
the application of large language model in emergency chest pain triage

Conditions: Chest Pain

Summary: this study will evaluate the accuracy and efficiency of large language model in emergency triage.

the study is to evaluate the value of large language model in emergency triage, their accuracy and efficiency were evaluated and compared with traditional triage. to explore whether the model can effectively reduce the workload of medical staff, while improving the speed and quality of triage. in addition, the ability of the model to predict serious medical events such as acute heart events and strokes was evaluated. it also included surveys of patients; acceptance and satisfaction with the use of the artificial intelligence-assisted triage system. analyze the economic benefits of adopting this technology, including cost saving and optimal allocation of resources.

Eligibility criteria:
inclusion criteria: 1. all patients with chest pain entered the emergency triage procedure. 2. patients aged 18 and above. exclusion criteria: 1. patients with severe cognitive impairment or inability to communicate. 2. there are patients who have been explicitly referred to specific departments (for example, some of the 120 transfer patients, who may go directly to the green channel) . 3. patients with unstable vital signs . 4. patients with potential medical problems. 5. is participating in other clinical trials. 6. failure to follow test procedures. 7. those who refuse to sign the informed consent form.

Keywords: large language model chest pain
prognosis of coronary stenosis based on intracoronary imaging; a multicenter, prospective observational study

Conditions: Coronary Artery Disease

Summary: the purpose of this study is to evaluate the prognosis of coronary stenosis based on intracoronary imaging.


Eligibility criteria:
inclusion criteria: * patients with intracoronary imaging * written consent exclusion criteria: * severe calcification and/or severe tortuosity * lesion with previous bypass graft surgery (cabg) * left ventricular ejection fraction less than 30 % * coronary spasm * life expectancy less than 2 years * pregnancy or breast-feeding

Keywords: coronary stenosis intracoronary imaging vh-ivus oct nirs gray scale ivus